Physical environment is one important social determinant of health. Where somebody lives and how they move around from place to place to access basic services such as grocery stores, health care and work greatly influences health. Physical environment such as indoor and outdoor air quality also affects health outcomes. Exposure to environmental toxins and other hazards such as lead influence health conditions. Opportunities for physical recreation, either built or natural, affects health behavior. Outdoor air quality is a strength in Curry County, consistently better than state and national air quality. The wildfire season in 2017 was particularly damaging and affected the air quality, but up until then, the particulate matter in the air was significantly lower than National Ambient Air Quality standards. Physical environment, including air quality and recreational opportunities, was overwhelming chosen as the biggest strength of the county, by participants in the 2018 CHA surveys and focus groups.